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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 306 Research Studies DisplayedRamanathan S, Evans CT, Hershow RC
Guideline concordance and antibiotic-associated adverse events between Veterans administration and non-Veterans administration dental settings: a retrospective cohort study.
The study aimed to evaluate antibiotic prophylaxis adherence and associated adverse drug events (ADEs) in dental settings. A retrospective cohort study of adults with cardiac conditions or prosthetic joints from 2015 to 2017 was conducted. Of 61,124 patients receiving antibiotic prophylaxis, 62 (0.1%) experienced ADEs. Guideline concordance was not linked to ADEs (adjusted OR: 0.78, 95% CI: 0.25-2.46), and this was consistent across different dental settings.
AHRQ-funded; HS025177.
Citation: Ramanathan S, Evans CT, Hershow RC .
Guideline concordance and antibiotic-associated adverse events between Veterans administration and non-Veterans administration dental settings: a retrospective cohort study.
Front Pharmacol 2024 Jan 16; 15:1249531. doi: 10.3389/fphar.2024.1249531.
Keywords: Antibiotics, Medication, Adverse Drug Events (ADE), Guidelines, Dental and Oral Health, Practice Patterns
Yan CH, Hubbard CC, Lee TA
Impact of hydrocodone rescheduling on dental prescribing of opioids.
In 2014, the United States Drug Enforcement Administration rescheduled hydrocodone’s controlled substance schedule from III to II, introducing increasing regulations in prescribing and dispensing. In the U.S., dentists often prescribe hydrocodone, and these changes in scheduling may have altered dental prescribing of opioids. The purpose of this study was to assess the impact of the hydrocodone rescheduling on dental prescribing of opioids in the United States. Across the 49-month study period, dentists prescribed 50,412,942 opioid prescriptions. Hydrocodone was the most prescribed opioid, followed by codeine, oxycodone, and tramadol. At index, hydrocodone prescribing immediately decreased by -834.8 Rx/1,000 dentists with increased prescribing of codeine, oxycodone, and tramadol. The mean MME increased at index for all opioids except for hydrocodone, and dosages subsequently decreased during the postindex period.
AHRQ-funded; HS025177.
Citation: Yan CH, Hubbard CC, Lee TA .
Impact of hydrocodone rescheduling on dental prescribing of opioids.
JDR Clin Trans Res 2023 Oct; 8(4):402-12. doi: 10.1177/23800844221102830..
Keywords: Opioids, Medication, Dental and Oral Health, Practice Patterns
Sankar A, Everhart AO, Jena AB
Longitudinal patterns in testosterone prescribing after US FDA safety communication in 2014.
This study described changes in testosterone prescribing following a 2014 US Food and Drug Administration (FDA) safety communication and how changes varied by physician characteristics. The authors extracted data from a 20% random sample of Medicare fee-for-service administrative claims data from 2011 through 2019. This unique sample included 1,544,604 unique male beneficiaries who received evaluation and management (E&M) services from 58,819 unique physicians that prescribed testosterone between 2011 and 2013. Patients were classified by presence of coronary artery disease (CAD) and non-age-related hypogonadism. Physician characteristics included specialty and affiliations with teaching hospitals, for-profit hospitals, hospitals in integrated delivery networks, and hospitals in the top decile of case mix index. Among 65,089,560 physician-patient-quarter-year observations, mean (standard deviation) age ranged from 72.16 (5.84 SD) years for observations without CAD or non-age-related hypogonadism to 75.73 (6.92 SD) years with CAD and without non-age-related hypogonadism. Following the safety communication, immediate changes in off-label testosterone prescription levels fell by 0.22 percentage points (pp) for patients with CAD and by -0.16 pp for patients without CAD, with a similar change in on-label prescribing levels. The off-label testosterone prescription quarterly trend increased for patients with CAD and without CAD; on-label testosterone prescription trends declined for both groups. Primary care physicians had larger declines in off-label prescribing then non-primary care physicians, and physicians affiliated with teaching compared to nonteaching hospitals. On-label prescribing found no changes associated with physician and organizational characteristics.
AHRQ-funded; HS025164.
Citation: Sankar A, Everhart AO, Jena AB .
Longitudinal patterns in testosterone prescribing after US FDA safety communication in 2014.
Jt Comm J Qual Patient Saf 2023 Sep; 49(9):458-66. doi: 10.1016/j.jcjq.2023.05.003..
Keywords: Communication, Medication, Practice Patterns
Bongiovanni T, Pletcher MJ, Lau C
A behavioral intervention to promote use of multimodal pain medication for hospitalized patients: a randomized controlled trial.
Administration of nonsteroidal anti-inflammatory drugs (NSAIDs) has become a foundational strategy to decrease the use of opioids, but data is lacking to describe recommending utilization when admitting patients using electronic health record systems. The purpose of this study was to assess an electronic health record system to increase ordering of NSAIDs for hospitalized adults. The researchers conducted a cluster randomized controlled trial of clinicians admitting adult patients to a health system over a period of 9-months. Clinicians in the intervention arm were required to actively order or decline NSAIDs; the control arm was provided the same order but without a required response. A total of 20,085 hospitalizations were included. The study found that among the hospitalizations, 52% were admitted by a clinician randomized to the intervention arm. NSAIDs were ordered in 22% of the interventions and 22% of the control admissions. There were no statistically significant differences in NSAID administration, pain scores, or opioid prescribing. There were no differences in clinical harms, with average pain scores of 3.36 in the control group and 3.39 in the intervention group, on a scale of 0-5.
AHRQ-funded; HS026383.
Citation: Bongiovanni T, Pletcher MJ, Lau C .
A behavioral intervention to promote use of multimodal pain medication for hospitalized patients: a randomized controlled trial.
J Hosp Med 2023 Aug; 18(8):685-92. doi: 10.1002/jhm.13153..
Keywords: Pain, Opioids, Medication, Behavioral Health, Practice Patterns
Miller-Rosales C, Busch SH, Meara ER
Internal and environmental predictors of physician practice use of screening and medications for opioid use disorders.
This study examined the extent of screening for opioid use and availability of medications for opioid use disorder (MOUD) in a national cross-section of multi-physician primary care and multispecialty practices. The authors found that a total of 26.2% of practices offered MOUD, while 69.4% of practices screened for opioid use. Offering of MOUD in a practice was associated with having advanced HIT functionality, while access to on-site behavioral clinicians was positively associated with offering MOUD in adjusted models.
AHRQ-funded; HS024075.
Citation: Miller-Rosales C, Busch SH, Meara ER .
Internal and environmental predictors of physician practice use of screening and medications for opioid use disorders.
Med Care Res Rev 2023 Aug; 80(4):410-22. doi: 10.1177/10775587231162681..
Keywords: Opioids, Substance Abuse, Behavioral Health, Screening, Medication, Practice Patterns
Gupta N, Kucirka L, Semerjian A
Practice patterns regarding female reproductive organ-sparing and nerve-sparing radical cystectomy among urologic oncologists in the United States.
The purpose of this study was to describe practice patterns regarding female reproductive organ-sparing (ROS) and nerve-sparing radical cystectomy nerve-sparing radical cystectomy (RC) among US urologists. The researchers conducted a cross-sectional survey of members of the Society of Urologic Oncology to evaluate provider-reported frequency of ROS and nerve-sparing RC in premenopausal and postmenopausal patients with non-muscle-invasive bladder cancer that failed intravesical therapy or clinically localized muscle-invasive bladder cancer. The study found that among 101 urologists, 79.2% reported that they routinely resect the uterus/cervix, 67.3% the neurovascular bundle, 48.5% the ovaries, and 18.8% a portion of the vagina when performing RC in premenopausal patients with organ-confined disease. When asked about changes to approach in postmenopausal patients, 70.3% reported that they were less likely to spare the uterus/cervix, 43.6% were less likely to spare the neurovascular bundle, 69.3% were less likely to spare the ovaries, and 22.8% were less likely to spare a portion of the vagina.
AHRQ-funded; HS026120.
Citation: Gupta N, Kucirka L, Semerjian A .
Practice patterns regarding female reproductive organ-sparing and nerve-sparing radical cystectomy among urologic oncologists in the United States.
Clin Genitourin Cancer 2023 Aug; 21(4):e236-e41. doi: 10.1016/j.clgc.2023.01.010..
Keywords: Practice Patterns, Women, Sexual Health, Surgery, Cancer
Ramanathan S, Evans CT, Hershow RC
Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints.
The objective of this retrospective study was to compare prescribing of antibiotic prophylaxis in Veterans Affairs (VA) and non-VA settings. Subjects were veteran and non-veteran dental patients with cardiac conditions or prosthetic joints; most were males aged 55 years older. The results showed that VA settings had a higher prevalence of guideline concordant prescribing among those with prosthetic joints, and when assessing dosing errors. The authors recommended that future studies focus on the extent to which integrated electronic health records may be responsible for increased guideline concordant prescribing in the VA setting.
AHRQ-funded; HS025177.
Citation: Ramanathan S, Evans CT, Hershow RC .
Comparison of guideline concordant antibiotic prophylaxis in Veterans Affairs and non-Veterans Affairs dental settings among those with cardiac conditions or prosthetic joints.
BMC Infect Dis 2023 Jun 23; 23(1):427. doi: 10.1186/s12879-023-08400-y..
Keywords: Dental and Oral Health, Antibiotics, Medication, Prevention, Cardiovascular Conditions, Practice Patterns
Kim KC, Khouja T, Burgette JM
Trends in dispensed prescriptions for opioids, sedatives, benzodiazepines, gabapentin, and stimulants to children by general dentists, 2012-2019.
This study examined trends in prescription fills for opioids, benzodiazepines, gabapentin, and stimulants to children <18 years from 2012 to 2019 in a national dataset comprising 92% of dispensed outpatient prescriptions by dentists. During this time, 3.8 million children filled prescriptions for high-alert drugs from general dentists. Opioids accounts for 69.4% of high-alert prescriptions, however from 2012 to 2019 fills for opioids, sedatives, benzodiazepines, and stimulants decreased by 65.2%, 43.4%, 43.6% and 89.3%, respectively. Gabapentin prescriptions increased by 8.1%. Older teenagers (15-17 years) received 42.5% of high-alert prescriptions. Low-income counties in Southern states were overrepresented among top-prescribing areas in 2019.
AHRQ-funded; HS025177.
Citation: Kim KC, Khouja T, Burgette JM .
Trends in dispensed prescriptions for opioids, sedatives, benzodiazepines, gabapentin, and stimulants to children by general dentists, 2012-2019.
Pharmacoepidemiol Drug Saf 2023 Jun; 32(6):625-34. doi: 10.1002/pds.5589..
Keywords: Children/Adolescents, Dental and Oral Health, Opioids, Medication, Practice Patterns
Sun EC, Rishel CA, Waljee JF
Association between state limits on opioid prescribing and the incidence of persistent postoperative opioid use among surgical patients.
The objective of this study was to examine whether laws limiting opioid prescribing were associated with reductions in the incidence of persistent postoperative opioid use. Over identified 950,000 privately insured patients who had undergone one of 10 procedures were identified; researchers then estimated the association between persistent postoperative opioid use and whether state opioid prescribing limits were in effect on the day of surgery. The findings suggested that laws limiting opioid prescriptions were not associated with subsequent reductions in persistent postoperative opioid use.
AHRQ-funded; HS026753.
Citation: Sun EC, Rishel CA, Waljee JF .
Association between state limits on opioid prescribing and the incidence of persistent postoperative opioid use among surgical patients.
Ann Surg 2023 Apr;277(4):e759-e65. doi: 10.1097/sla.0000000000005283.
Keywords: Opioids, Medication, Surgery, Substance Abuse, Practice Patterns
Nguyen T, Meille G, Buchmueller T
AHRQ Author: Meille G
Mandatory prescription drug monitoring programs and overlapping prescriptions of opioids and benzodiazepines: evidence from Kentucky.
This AHRQ-authored study examined how overlapping benzodiazepine and opioid prescription rates changed after Kentucky implemented a PDMP mandate in July 2012 in response to the opioid epidemic. The authors conducted an interrupted time series analysis using monthly data from Kentucky's PDMP from 2010 to 2016. They also conducted an individual-level longitudinal analysis that compared changes in utilization patterns after the mandate went into effect to changes in earlier periods during which the mandate was not in effect. The PDMP mandate was associated with an immediate 7.5 % decline in the rate of overlapping benzodiazepine and opioid prescriptions and a significant change in the trend from increasing to decreasing. A single provider was responsible for approximately half of the immediate effect in level terms who was writing overlapping benzodiazepine and opioid prescriptions. Their longitudinal analysis suggests that over one year the mandate reduced initiation of overlapping prescriptions by 29.3 % and reduced continuation of overlapping prescriptions by 9.4 %, with effects of the policy being largest for women and men aged 36-50.
AHRQ-authored.
Citation: Nguyen T, Meille G, Buchmueller T .
Mandatory prescription drug monitoring programs and overlapping prescriptions of opioids and benzodiazepines: evidence from Kentucky.
Drug Alcohol Depend 2023 Feb 1; 243:109759. doi: 10.1016/j.drugalcdep.2022.109759..
Keywords: Opioids, Medication, Practice Patterns
Coburn SB, Lang R, Zhang J
Statins utilization in adults with HIV: the treatment gap and predictors of statin initiation.
The purpose of this study was to describe trends in statin eligibility and subsequent statin initiation among people with HIV (PWH) from and identify the predictors of statin initiation. The researchers collected data from 12 United States cohorts between 2001 and 2017. The study found that among 16,409 PWH, 45% met statin eligibility criteria per guidelines for the time period from 2001 to 2017. Statin eligibility ranged from 22% to 25% from 2001 to 2013, and initiation increased from 13% to 45%. In 2014, 51% were statin-eligible, among whom 25% initiated statins, which increased to 32% by 2017. The researchers concluded that there is a substantial statin treatment gap, expanded by the 2013 ACC/AHA guidelines.
AHRQ-funded; 90047713.
Citation: Coburn SB, Lang R, Zhang J .
Statins utilization in adults with HIV: the treatment gap and predictors of statin initiation.
J Acquir Immune Defic Syndr 2022 Dec 15;91(5):469-78. doi: 10.1097/qai.0000000000003083..
Keywords: Medication, Human Immunodeficiency Virus (HIV), Access to Care, Practice Patterns, Cardiovascular Conditions
Varady NH, Worsham CM, Chen AF
Inappropriate prescribing of opioids for patients undergoing surgery.
This study examined inappropriate prescribing of opioids for patients undergoing surgery, in this instance prescribing them to a patient’s spouse. Among 450,125 opioid-naïve couples with commercial insurance studied, for patients who did not fill perioperative opioid prescriptions themselves, the rate of spousal fills on the day of surgery (DOS) was 2.39 fills per 1,000 surgeries compared with 0.44 fills on all other perioperative days. Increases in spousal fills were not present for patients that filled opioid prescriptions themselves.
AHRQ-funded; HS026753.
Citation: Varady NH, Worsham CM, Chen AF .
Inappropriate prescribing of opioids for patients undergoing surgery.
Proc Natl Acad Sci U S A 2022 Dec 6;119(49):e2210226119. doi: 10.1073/pnas.2210226119..
Keywords: Opioids, Medication, Surgery, Practice Patterns, Provider: Physician
Parikh MA, Fabiyi C, Mistry KB
AHRQ Author: Fabiyi C, Mistry KB
Factors associated with postprocedure opioid prescribing and persistent opioid use among opioid-naive patients: A nationally representative sample.
This study’s objective was to examine factors associated with postprocedure opioid receipt and persistent opioid use among opioid-naive patients in a nationally representative sample. The authors used panels 18-20 in MEPS between the years 2013 and 2015. They found that younger age, Western location, and a high-school degree were associated with higher odds of postprocedure opioid receipt. Patients who had procedures in an inpatient, outpatient, and dental setting; or musculoskeletal diagnoses and injuries were more likely to have postprocedure opioid receipt. Persistent opioid use was associated with Midwest and Northeast location, musculoskeletal diagnosis, public insurance, and positive depression screening.
AHRQ-authored.
Citation: Parikh MA, Fabiyi C, Mistry KB .
Factors associated with postprocedure opioid prescribing and persistent opioid use among opioid-naive patients: A nationally representative sample.
Ann Surg 2022 Dec 1;276(6):e706-e13. doi: 10.1097/sla.0000000000004630..
Keywords: Medical Expenditure Panel Survey (MEPS), Opioids, Medication, Practice Patterns, Pain
Carlile N, Fuller TE, Benneyan JC
Lessons learned in implementing a chronic opioid therapy management system.
This article describes a research collaborative of health service researchers, systems engineers, and clinicians that sought to improve processes for safer chronic opioid therapy management in an academic primary care center. The authors present implementation results and lessons learned along with an intervention toolkit that others may consider using within their organization. They designed, tested, and implemented two key safe opioid use process metrics-percent for patients with recent opioid treatment agreements and urine drug tests. Focus groups were conducted after the conclusion of the implementation. They found a general lack of knowledge regarding resources available to patients and prescribers in the primary care clinic. In addition, 69% of clinicians reported largely “inheriting” (rather than initiating) their chronic opioid therapy patients. They also tracked 68 patients over a 4-year period and found although process measures improved, full adherence was not achieved for the entire population. Barriers identified included team structure, the evolving opioid environment, and surveillance challenges, along with disruptions resulting from the 2019 novel coronavirus.
AHRQ-funded; HS024453.
Citation: Carlile N, Fuller TE, Benneyan JC .
Lessons learned in implementing a chronic opioid therapy management system.
J Patient Saf 2022 Dec 1;18(8):e1142-e49. doi: 10.1097/pts.0000000000001039..
Keywords: Opioids, Medication, Pain, Chronic Conditions, Substance Abuse, Behavioral Health, Practice Patterns
Bongiovanni T, Gan S, Finlayson E
Prolonged use of newly prescribed gabapentin after surgery.
This study investigated postoperative prolonged gabapentin use in adults 65 years and older. The authors merged a 20% sample of Medicare Carrier, MedPAR, and Outpatient Files with Part D for 2013-2018. They defined new postoperative gabapentin as fills for 7 days before surgery until 7 days after discharge. Overall, 3% of all eligible patients (n = 17,970) had a new prescription for gabapentin postsurgery. Out of those, the mean age was 73 years old and 62% were female. The most common surgeries that gabapentin was prescribed for was total knee (45%) and total hip (21%) replacements. Prolonged use occurred in 22% of patients, with women, non-White, those with concurrent prolonged opioid use, and patients having undergone emergency surgery more likely to have prolonged use.
Citation: Bongiovanni T, Gan S, Finlayson E .
Prolonged use of newly prescribed gabapentin after surgery.
J Am Geriatr Soc 2022 Dec;70(12):3560-69. doi: 10.1111/jgs.18005..
Keywords: Medication, Surgery, Pain, Elderly, Practice Patterns
Toce MS, Michelson KA, Chen KY
Trends in dispensing of controlled medications for US adolescents and young adults, 2008 to 2019.
This retrospective cohort analysis examined pharmacy insurance claims for trends in dispensation of controlled medications to adolescents and young adults. The subjects were youths aged 13 to 25 years and enrolled in a commercial health insurance company covering individuals in all fifty states. The results showed that the prevalence of dispensed stimulants increased significantly among youths with commercial insurance; by contrast, the prevalence of dispensed depressants and narcotics decreased, although it remained higher in young adults than in adolescents under 18. The authors noted that use of a commercial insurance data set may affect generalizability to other populations, and that pronounced differences in the dispensing of controlled substances based on sex offered opportunities for further investigation.
AHRQ-funded; HS026503.
Citation: Toce MS, Michelson KA, Chen KY .
Trends in dispensing of controlled medications for US adolescents and young adults, 2008 to 2019.
JAMA Pediatr 2022 Dec;176(12):1265-66. doi: 10.1001/jamapediatrics.2022.3312.
Keywords: Children/Adolescents, Young Adults, Medication, Practice Patterns
Wurcel AG, Essien UR, Ortiz C
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
This cohort study examined antibiotics prescribed and variations by race among hospitalized patients with skin and soft tissue infections (SSTIs). A subanalysis of multisite, cross-sectional data collected through a national survey of acute care hospital groups within Vizient, Inc. considering adult inpatients treated for SSTIs was used. Of the 1242 adult inpatients included from 91 US hospitals, 45% were female, 18% were Black, and 69% were White with a mean age of 58 years. Penicillin allergy with hives was found in 23%, 19% with rash, and 18% with unknown effects, with allergy found more frequent in Black patients (23%) versus White (18%). Adjusting for multiple factors, White inpatients were at an increased risk of cefazolin use and decreased risk of clindamycin use compared with Black inpatients. Cefazolin use with less likely to be prescribed to Black inpatients than White inpatients and they were likely to be prescribed clindamycin. Cefazolin is considered a first-line SSTI treatment with clindamycin not recommended given frequent dosing and high potential for adverse effects including Clostridioides difficile infection (CDI). Although penicillin allergy is described as more prevalent among White patients, the authors observed an increased prevalence among Black inpatients compared with White inpatients treated for SSTI.
Citation: Wurcel AG, Essien UR, Ortiz C .
Variation by race in antibiotics prescribed for hospitalized patients with skin and soft tissue infections.
JAMA Netw Open 2021 Dec;4(12):e2140798. doi: 10.1001/jamanetworkopen.2021.40798..
Keywords: Antibiotics, Skin Conditions, Racial and Ethnic Minorities, Practice Patterns, Medication
Guzman A, Brown T, Lee JY
Look-back and look-forward durations and the apparent appropriateness of ambulatory antibiotic prescribing.
Researchers assessed how the apparent appropriateness of antibiotic prescribing changes when using different look-back and look-forward periods. Classifying all ambulatory antibiotic prescriptions in the electronic health record of an integrated health care system as chronic, appropriate, potentially appropriate, inappropriate, or not associated with any diagnosis, they concluded that ambulatory programs and studies focused on appropriate or inappropriate antibiotic prescribing can reasonably use a short duration of association between an antibiotic prescription and diagnosis codes. They further indicated that programs and studies focused on potentially appropriate antibiotic prescribing might consider examining longer durations.
AHRQ-funded; HS024930.
Citation: Guzman A, Brown T, Lee JY .
Look-back and look-forward durations and the apparent appropriateness of ambulatory antibiotic prescribing.
Antibiotics 2022 Nov 4;11(11). doi: 10.3390/antibiotics11111554..
Keywords: Antibiotics, Antimicrobial Stewardship, Medication, Ambulatory Care and Surgery, Practice Patterns
Togun AT, Karaca-Mandic P, Wurtz R
Changes in opioid marketing practices after release of the CDC guidelines.
This study investigated changes in opioid marketing practices after release of the 2016 CDC guidelines. The study’s objectives were to (1) evaluate whether the release of the guidelines was associated with changes in total monthly marketing spending received per physician, monthly marketing encounter frequency per physician, and spending per encounter during opioid marketing; and (2) evaluate whether such changes in marketing differed between specialist physicians and primary care physicians (PCPs) and between urban and rural primary care service areas (PCSAs). This retrospective observational cross-sectional study used opioid marketing spending data from the CMS Open Payments database between August 2013 and December 2017. After release of the CDC guidelines the monthly number of marketing encounters per physician and total monthly amount received per physician decreased, but the amount spent at each marketing encounter increased. There was an immediate increase in level of opioid marketing spending per encounter by $0.59 and an over-time increase in rate of spending per encounter of $0.04 per month.
AHRQ-funded; HS025164.
Citation: Togun AT, Karaca-Mandic P, Wurtz R .
Changes in opioid marketing practices after release of the CDC guidelines.
Am J Manag Care 2022 Oct;28(10):507-13. doi: 10.37765/ajmc.2022.89248..
Keywords: Opioids, Medication, Practice Patterns
Warren DK, Peacock KM, Nickel KB
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
The authors investigated factors associated with post-discharge prophylactic antibiotic use after mastectomy with and without immediate reconstruction and the impact on surgical-site infection (SSI). They found that anti-methicillin-sensitive Staphylococcus aureus antibiotics were associated with decreased risk of SSI for patients who had mastectomy only and those who had mastectomy with immediate reconstruction. They concluded that the high numbers needed to treat suggest that potential benefits of post-discharge antibiotics should be weighed against potential harms associated with antibiotic overuse.
AHRQ-funded; HS019455.
Citation: Warren DK, Peacock KM, Nickel KB .
Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.
Infect Control Hosp Epidemiol 2022 Oct;43(10):1382-88. doi: 10.1017/ice.2021.400..
Keywords: Antibiotics, Cancer: Breast Cancer, Cancer, Medication, Surgery, Healthcare-Associated Infections (HAIs), Prevention, Women, Practice Patterns
Khouja T, Polk DE, Suda KJ
Opioid prescribing by oral and maxillofacial surgeons in the United States, 2016-2019.
The objective of this study was to describe opioid prescribing trends among oral and maxillofacial surgeons (OMFS). The IQVIA Longitudinal Prescription Dataset, 2016-2019, was used to identify prescriptions written by OMFS. The results indicated that while OMFS-prescribed hydrocodone and oxycodone decreased in most states, 12 percent of states showed increases. Tramadol and codeine prescriptions also increased. From these findings, the authors concluded that targeted interventions are warranted in some areas.
AHRQ-funded; HS025177.
Citation: Khouja T, Polk DE, Suda KJ .
Opioid prescribing by oral and maxillofacial surgeons in the United States, 2016-2019.
J Public Health Dent 2022 Sep;82(4):491-94. doi: 10.1111/jphd.12544..
Keywords: Opioids, Medication, Practice Patterns, Orthopedics, Surgery, Dental and Oral Health, Provider: Physician
Cuellar A, Pomeroy JML, Burla S
Quality of antibiotic prescribing in a large direct-to-patient telehealth program: an observational study.
This study looked at the quality of antibiotic prescribing in direct-to-patient (DTP) telehealth visits compared to primary care visits, retail clinics, urgent care, or emergency department (ED). Claims were examined for 2,400,198 visits who were continually enrolled with a large national health insurer during 2016-2017 and treated for acute respiratory infection (ARI), or for women uncomplicated UTI. For streptococcal pharyngitis, the authors further measured whether a culture or rapid Group A Streptococcus test was done. Antibiotic prescription management for ARIs and UTIs was guideline-concordant comparable between televisits and several other settings. Patients with pharyngitis who received antibiotics were less likely to receive rapid Strep testing for televisits compared with primary care, retail clinics, urgent care, and EDs.
AHRQ-funded; HS025163.
Citation: Cuellar A, Pomeroy JML, Burla S .
Quality of antibiotic prescribing in a large direct-to-patient telehealth program: an observational study.
J Gen Intern Med 2022 Sep;37(12):3202-04. doi: 10.1007/s11606-021-07354-8..
Keywords: Antibiotics, Medication, Telehealth, Health Information Technology (HIT), Practice Patterns
Mitchell JM, Gresenz CR
The influence of practice structure on urologists' treatment of men with low-risk prostate cancer.
Researchers examined the influence of type of practice structure, and by implication the financial incentives associated with each structure, on treatment received among men newly diagnosed with low-risk prostate cancer. They found that physician practice structure attributes were significantly associated with type of treatment received but few studies controlled for such factors. Their findings - coupled with the observation that urologist practice structure shifted substantially over this time period due to mergers of small urology groups - provided one explanation for the limited uptake of active surveillance among men with low-risk disease in the US.
AHRQ-funded; HS024972.
Citation: Mitchell JM, Gresenz CR .
The influence of practice structure on urologists' treatment of men with low-risk prostate cancer.
Med Care 2022 Sep;60(9):665-72. doi: 10.1097/mlr.0000000000001746..
Keywords: Cancer: Prostate Cancer, Cancer, Practice Patterns, Men's Health, Provider: Physician
Khouja T, Zhou J, Gellad WF
Serious opioid-related adverse outcomes associated with opioids prescribed by dentists.
This study’s objective was to evaluate adverse outcomes and persistent opioid use (POU) after opioid prescriptions by dentists, based on whether opioids were overprescribed or within recommendations. A cross-sectional analysis of adults with dental visit and corresponding opioid prescription from 2011 to 2017 within a nationwide commercial claims database was conducted. As per CDC guidelines, opioid overprescribing was defined as >120 morphine milligram equivalents. Of 633,387 visits, 16.6% had POU and 2.6% experienced an adverse outcome. POU was higher when opioids were overprescribed with visits associated with mild pain and those with substance use disorders having the highest risk of both outcomes.
AHRQ-funded; HS025177.
Citation: Khouja T, Zhou J, Gellad WF .
Serious opioid-related adverse outcomes associated with opioids prescribed by dentists.
Pain 2022 Aug 1;163(8):1571-80. doi: 10.1097/j.pain.0000000000002545..
Keywords: Opioids, Dental and Oral Health, Substance Abuse, Behavioral Health, Practice Patterns, Pain, Medication, Adverse Drug Events (ADE), Adverse Events
Marks MR, Dux MC, Rao V
Treatment patterns of anxiety and posttraumatic stress disorder following traumatic brain injury.
Investigators examined psychotropic medication use and psychotherapy patterns among individuals diagnosed with anxiety disorders and PTSD post-traumatic brain injury (TBI). They found that receipt of pharmacotherapy pre- and post-TBI was considerably more common than receipt of psychotherapy. Individuals diagnosed with anxiety were 66% less likely to receive psychotherapy compared with individuals diagnosed with PTSD. Overall, psychotropic medication use and rates of antidepressant prescription use in the anxiety group were higher compared to those in the PTSD group.
AHRQ-funded; HS024560.
Citation: Marks MR, Dux MC, Rao V .
Treatment patterns of anxiety and posttraumatic stress disorder following traumatic brain injury.
J Neuropsychiatry Clin Neurosci 2022 Summer;34(3):247-53. doi: 10.1176/appi.neuropsych.21040104..
Keywords: Anxiety, Behavioral Health, Trauma, Brain Injury, Treatments, Practice Patterns, Medication